Provider Demographics
NPI:1194053520
Name:TORIBIO, IVY
Entity type:Individual
Prefix:
First Name:IVY
Middle Name:
Last Name:TORIBIO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6650 CORPORATE CENTER PKWY
Mailing Address - Street 2:APT. 209
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-0988
Mailing Address - Country:US
Mailing Address - Phone:904-514-1918
Mailing Address - Fax:
Practice Address - Street 1:1750 STOCKTON ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32204-4664
Practice Address - Country:US
Practice Address - Phone:904-308-4700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-23
Last Update Date:2009-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist